Doctor, What Else Can You Do For My Wife?

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Admission to Psychiatric Unit• Admitted to Psychiatric Unit because ofrelapse of psychotic and affective symptoms• She was busy taking care of her auntie• More depressed with more crying spells• Delusion of guilt (thought she had killed orharmed a lot of people)• Vague suicidal idea but no action plan• Occasional irrelevant speech
Day 1Transfer from Psychiatric Unitto Medical Unit• 8 Days after Admission to Psychiatric Unit,• She developed desaturation (SaO2 88% RA) andnasogastric tube inserted for poor oral feedingshowed coffee ground aspirate• No fever or tarry stool• Medications in Psychiatric Unit:• Risperidone 5mg daily• Fluoxetine10mg daily• Transferred to Medical Unit for furthermanagement
Page 1 and 2: Doctor,What else can You do for My
Page 3: Madam Tang• Past Medical History:
Page 7 and 8: Day 1Special Observation Ward• Af
Page 9 and 10: Day 2Transfer to Cohort Ward• Tra
Page 12 and 13: Discussion:What are the Differentia
Page 14 and 15: Day 1-2Investigations• Complete B
Page 16 and 17: Day 2ECG
Page 18 and 19: Day 2Chest X-Ray
Page 20 and 21: Day 2CT Brain (Plain) Report• No
Page 22 and 23: Day 1-4Temperature ChartD1 D2 D3 D4
Page 24 and 25: Summary / Problemsat this Juncture1
Page 26 and 27: Day 5Lumbar Puncture• Lumbar Punc
Page 28 and 29: Day 1-9Temperature ChartD1 D2 D3 D4
Page 30 and 31: Day 8Septic Workup• Sputum cultur
Page 32 and 33: Day 8Advice fromInfectious Disease
Page 34 and 35: Day 11-15Temperature ChartD11 D12 D
Page 36 and 37: Day 10Patient Reviewed Again• Fev
Page 38 and 39: 23Discussion:What are the Different
Page 40 and 41: Discussion:What else Can We Do?•
Page 42 and 43: Discussion:NMS: Clinical Features
Page 44 and 45: Day 10The Clinical Picture is Compa
Page 46 and 47: Day 5-8Blood Pressure/Pulse ChartHy
Page 48 and 49: Discussion:Is Elevated Creatine Kin
Page 50 and 51: Day 1-10Temperature ChartD1 D2 D3 D
Page 52 and 53: Discussion:What else Can We Do?Can
Page 54 and 55:
Day 10Drug Record in Our PatientFlu
Page 56 and 57:
Discussion:Why is so Important to D
Page 58 and 59:
Conclusion:Most Likely Diagnosis in
Page 60 and 61:
Discussion:NMS: Epidemiology• Inc
Page 62 and 63:
Discussion:Why does this Patient be
Page 64 and 65:
Discussion:What is So Special in Ou
Page 66 and 67:
Discussion:NMS in Elderlyhttp://hk.
Page 68 and 69:
Discussion:NMS in Elderly• Increa
Page 70 and 71:
Discussion:Why does our Patient wit
Page 72 and 73:
Discussion:Treatment of NMS• Mild
Page 74 and 75:
Discussion:Treatment of NMS:Dantrol
Page 76 and 77:
Day 11-22Temperature ChartD11 D12 D
Page 78 and 79:
Day 12-24Progress• Physiotherapy:
Page 80 and 81:
Day 35Progress inConvalescent Hospi
Page 82 and 83:
Day 103Discharge• Upon Discharge-
Page 84 and 85:
Discussion:SUMMARYWhat Have I Learn
Page 86 and 87:
Discussion:What Have I Learned from
Page 88 and 89:
After Discharge• Followed Up in M
Page 90 and 91:
Discussion:Anti-Psychotics in Elder
Page 92 and 93:
Discussion:NMS after Anti-Psychotic
Page 94 and 95:
Discussion:Age-Related Physiologica
Page 96 and 97:
Discussion:NMS in ElderlyNeurolepti
Page 98 and 99:
Day 2Abdominal X-Ray
Page 100 and 101:
Discussion:What are the Differentia
Page 102 and 103:
Day 5Lumbar Puncture• Lumbar Punc
Page 104 and 105:
Typical vs. Atypical Anti-Psychotic
Page 106 and 107:
Discussion:Risk Factors of NMS• D
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Doctor, What Else Can You Do For My Wife?

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